Walburn Jessica, Vedhara Kavita, Hankins Matthew, Rixon Lorna, Weinman John
Institute of Psychiatry, Department of Psychology, King's College London, SE1 9RT London, UK.
J Psychosom Res. 2009 Sep;67(3):253-71. doi: 10.1016/j.jpsychores.2009.04.002. Epub 2009 Jul 2.
The current review aims to synthesize existing knowledge about the relationship between psychological stress and wound healing.
A systematic search strategy was conducted using electronic databases to search for published articles up to the end of October 2007. The reference lists of retrieved articles were inspected for further studies and citation searches were conducted. In addition, a meta-analysis of a subset of studies was conducted to provide a quantitative estimation of the influence of stress on wound healing.
Twenty-two papers met the inclusion criteria of the systematic review and a subsample of 11 was included in a meta-analysis. The studies assessed the impact of stress on the healing of a variety of wound types in different contexts, including acute and chronic clinical wounds, experimentally created punch biopsy and blister wounds, and minor damage to the skin caused by tape stripping. Seventeen studies in the systematic review reported that stress was associated with impaired healing or dysregulation of a biomarker related to wound healing. The relationship between stress and wound healing estimated by the meta-analysis was r=-0.42 (95% CI=-0.51 to -0.32) (P<.01).
Attention now needs to be directed towards investigating potential moderators of the relationship, mediating mechanisms underpinning the association, as well as the demonstration of a causal link by the development of experimental interventions in healthy populations.
本综述旨在综合现有关于心理压力与伤口愈合之间关系的知识。
采用电子数据库进行系统检索策略，以查找截至2007年10月底发表的文章。检查检索到的文章的参考文献列表以获取进一步的研究，并进行引文检索。此外，对一部分研究进行了荟萃分析，以定量估计压力对伤口愈合的影响。
22篇论文符合系统综述的纳入标准，11篇的子样本纳入了荟萃分析。这些研究评估了压力在不同情况下对各种伤口类型愈合的影响，包括急性和慢性临床伤口、实验性创缘活检和水疱伤口，以及胶带剥离对皮肤造成的轻微损伤。系统综述中的17项研究报告称，压力与愈合受损或与伤口愈合相关的生物标志物失调有关。荟萃分析估计的压力与伤口愈合之间的关系为r = -0.42（95%CI = -0.51至-0.32）（P <.01）。
现在需要关注研究这种关系的潜在调节因素、支撑该关联的中介机制，以及通过在健康人群中开展实验性干预来证明因果关系。
